Agreement between Sanders classification of intraarticular calcaneal fractures and assessment during the surgery

Vosoughi, Amir Reza; Shayan, Zahra; Salehi, E; Jaberi, Fereidoon Mojtahed; Solooki, Saeed; Kardeh, Bahareh

doi:10.1016/j.fas.2018.12.001

Cited by 20 publications

(12 citation statements)

References 19 publications

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“…Das 12 fraturas analisadas, havia 8 homens (9 fraturas) e 3 mulheres, sendo 5 do lado esquerdo, 7 do direito e média de idade de 44,5 anos (31 a 59). A tabela 5 representa a avaliação da reprodutibilidade e a concordância obtida estratificando por tempo de experiência e por nível de atuação (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) . Com base nos dados, observa-se que os cirurgiões menos experientes, tanto do ponto de vista de tempo de atuação quanto de porcentagem de atuação, tiveram concordância intraobservador estatisticamente superior ao grupo dos mais experientes.…”

Section: Resultsunclassified

Intra and interobserver analysis of the Sanders classification for calcaneal fractures

et al. 2019

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Objective: To evaluate the intra and interobserver variation in the Sanders classification of calcaneal fractures and the clinical-radiological correlation of postoperative X-ray images and computed tomography (CT) scans. Methods: We sent pre- and postoperative images in the form of a questionnaire to 18 foot and ankle surgeons with varying experience and examined evaluations of the postoperative reduction and Sanders classification quality criteria of 12 calcaneal fractures. The kappa (Ƙ) values were calculated and compared to those in the literature, and the quality of the reduction was compared to the patient's American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS-AHS) score. Results: The mean intraobserver Ƙ of the Sanders classification was 0.49. Disregarding the subclasses, the intraobserver Ƙ was 0.55, and when type III and IV fractures were grouped, the intraobserver Ƙ was 0.57. The interobserver Ƙ values in these same three conditions were 0.22, 0.20, and 0.21, respectively. We also observed that the group of less experienced surgeons showed better intraobserver Ƙ values than the more experienced surgeons. In the analysis of the reduction quality based on X-ray images and the AOFAS-AHS score of the patient, we found a value of p=0.043. Conclusion: The Ƙ values were consistent with previous studies, confirming moderate intraobserver reproducibility and acceptable interobserver reliability. We also confirmed the presence of a significant relationship between the reduction quality based on X-ray images and the AOFAS-AHS score of the patient. Level of Evidence III; Diagnostic Studies; Nonconsecutive patients, no uniformly applied reference gold standard.

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Section: Resultsunclassified

Intra and interobserver analysis of the Sanders classification for calcaneal fractures

et al. 2019

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“…This study was approved by the Ethics Committee of the Third Hospital of Hebei Medical University, according to the Helsinki Declaration, and written informed consent was obtained from all participants. [7,17,18]. The kappa (κ) statistics was used to calculate inter-and intra-observer 118 variations.…”

Section: Introductionmentioning

confidence: 99%

CT-Based Classification Systems for Intra-Articular Calcaneal Fractures: The Inter- and Intraobserver Variations as well as Integrality

Wang

Liang

Wang

et al. 2022

The Journal of Foot and Ankle Surgery

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Background: Several primary fracture classification systems (FCSs) have been widely used for intra-articular calcaneal fractures. The purpose of this study was to measure the inter-and intra-observer variations as well as integrality of the Zwipp, Crosby-Fitzgibbons, Sanders, and Eastwood-Atkins classification systems based on more accurate CT scans.Methods: 549 patients with intra-articular calcaneal fractures taken from a database in our level-I trauma centre (3 affiliated hospitals) were included from January 2018 to December 2019. For each case, normative CT (1 mm slices) scans were available.Four different observers reviewed all CT scans two times according to these 4 most prevalent FCSs within a 2-month interval. For these four FCSs, the kappa [κ] coefficient was used to evaluate interobserver reliability and intraobserver reproducibility, and the percentage that can be classified was used to indicate integrality. Results:The κ values were measured for Zwipp (κ= 0.38 interobserver, κ= 0.61 intraobserver), Crosby-Fitzgibbons (κ= 0.48 interobserver, κ= 0.79 intraobserver), Sanders (κ= 0.40 interobserver, κ= 0.57 intraobserver), and Eastwood-Atkins (κ= 0.44 interobserver, κ= 0.72 intraobserver). Furthermore, the integrality were calculated for Zwipp (100 %), Crosby-Fitzgibbons (100 %), Sanders (92 %) as well as Eastwood-Atkins (89.6 %). Conclusion:Compared with previous literatures, CT scanning with higher accuracy can significantly improve intraobserver reproducibility of Zwipp and Eastwood-Atkins FCSs, but it has no positive effect on variability of Sanders FCS and interobserver reliability of Crosby-Fitzgibbons FCS. While in terms of integrality, Zwipp and Crosby-Fitzgibbons FCSs appear to be superior to the other two FCSs.

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“…Calcaneus fracture is a common clinical event that accounts for about 0.4-2% of all fractures and approximately 60-75% of tarsal bone related fractures (1)(2)(3). It remains difficult to manage surgically due to the irregular anatomical shape similar to cuboid, varied thickness of the surrounding soft tissues, and poor blood supply, resulting in burden of living quality and health care.…”

Section: Introductionmentioning

confidence: 99%

The epidemiology and clinical features of calcaneus osteomyelitis following calcaneus fracture: a retrospective study of 127 cases

Huang¹,

Guo²,

Zhu³

2021

Ann Palliat Med

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Background: To analyze the epidemiology and features of calcaneus osteomyelitis following open reduction and internal fixation (ORIF) after closed calcaneus fracture.Methods: We retrospectively analyzed 127 cases who were diagnosed with calcaneal osteomyelitis following ORIF via the extended lateral "L-shaped" approach after closed calcaneus fracture between March 2016 and August 2019 in our hospital. We analyzed participant demographics including gender, age, body mass index (BMI), trauma mechanism, Sanders classification, co-morbidity, time between initial injury and surgery, operating time, soft tissue stripping tools, tourniquet pressure, bone grafting option, internal fixation option, presence of bleeding after tourniquet deflation, and drainage option.Results: The majority of cases (n=127) were male (4.5 times more than female gender), at a ratio of 4.47:1.Falling from height was the main trauma mechanism (79.53%), followed by traffic accident (14.17%), and jumping (6.3%). A total of 51 cases (40.16%) were left-side fractures, and 76 (59.84%) were right-sided.According to the Sanders classification, 12 cases were type II (9.45%), 61 cases were type III (48.03%), and 54 cases were type IV (42.52%). There were 25 participants with the co-morbidity of type 2 diabetes mellitus (19.69%), 7 with hypertension (5.51%), and 1 case each of psoriasis and sicca syndrome (0.8%). The mean time to surgery was 4.7 days (4-9 days), and 123 participants (96.85%) were treated within 7 days. The mean operating time was 102.1 min (75-135 min). Forty-four participants (34.65%) received the conventional scalpel and 83 participants (65.35%) the electric scalpel during soft tissue stripping intraoperatively. The mean tourniquet pressure was 432.3 mmHg (350-550 mmHg). Autologous bone grafting was observed in 6 cases (4.72%), allograft bone grafting in 11 cases (8.67%), and OsteoSet grafting in 7 cases (5.51%).A locking plate was used in 114 cases (89.76) while anatomical plate in 13 cases (10.24%). A total of 27 participants (21.26%) bled after tourniquet deflation. Drainage tubes were applied in 30 participants (23.62%) while rubber drainage strips in 5 participants (3.94%).Conclusions: Young males dominated the calcaneus osteomyelitis following traumatic calcaneus fracture cohort in this study. A fall from height was the most frequent trauma mechanism. The presence of severe calcaneus fracture, Sanders type III (48.03%) and type IV (42.52%), were the common fracture types in this population group.

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Agreement between Sanders classification of intraarticular calcaneal fractures and assessment during the surgery

Cited by 20 publications

References 19 publications

Intra and interobserver analysis of the Sanders classification for calcaneal fractures

Intra and interobserver analysis of the Sanders classification for calcaneal fractures

CT-Based Classification Systems for Intra-Articular Calcaneal Fractures: The Inter- and Intraobserver Variations as well as Integrality

The epidemiology and clinical features of calcaneus osteomyelitis following calcaneus fracture: a retrospective study of 127 cases

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